The puppy was no bigger than a bag of flour, crouched in a damp corner of cement, shivering against a chain-link fence. The brown Labrador-terrier mix whimpered at anyone who walked by, but his own cries were drowned out on this frigid morning by the louder barks and howls of dozens and dozens of other dogs at the Sacramento County Animal Shelter.

At this overwhelmed county shelter, just a little over one in five animals actually finds a new home. Yet this puppy beat the odds. A family came along and fell in love, and soon the brown bundle was wriggling in the arms of a beaming 12-year-old boy--a birthday present, ready to head to a grassy back yard.

"I'm going to name him Bruiser," said Miguel Hernandez, as his nose, cheeks and ears were being smothered in puppy kisses. His two younger sisters clamored to also hold their new addition, who reveled in the attention.

"That right there makes everything I do worthwhile," said Kate Hurley, director of the Shelter Medicine Program at the UC Davis School of Veterinary Medicine. "That boy has just met the love of his life, and so has that puppy. I've helped to save a life, and made someone else's life a lot richer."

'Battlefield medicine'

Just a few years ago, this story was unlikely to have a happy ending. Puppies at the Sacramento County shelter, and dozens of others up and down the West Coast, fell victim to major outbreaks of disease. Many were put to sleep before having a new chance at life -- simply because they were sick.

But some fundamental veterinary advice -- and a new UC Davis program aimed at educating veterinarians in the "battlefield medicine" required at animal shelters -- is now turning those circumstances around. Cleaner cages, faster diagnosis and better training have helped workers at shelters like the one in Sacramento County better fight disease, so more puppies and kittens now survive to be adopted.

At animal shelters nationwide, an average of 70 percent of all animals are euthanized. Many of them die because they have contracted diseases or displayed behavioral problems due to their confinement. Homelessness is the leading cause of suffering and death for companion animals, and anywhere from 4 million to 20 million end up in shelters each year. No one knows for certain just how many.

Regulations are scarce to nonexistent for shelters, many of which operate on precarious public funding, understaffed and undersized for the animal populations they aim to serve. It's unclear how many of California's 600 animal shelters have been able to hire staff veterinarians. There are no common standards for health care, no sanctions for massive outbreaks of illness. No single government agency is charged with regulation.

"It's really a vicious cycle," said Richard Timmons, director of the UC Davis Center for Animals in Society, which works closely with the campus Shelter Medicine Program. "You have cities, counties and in some cases very well-intentioned nonprofit organizations and rescue groups, all trying to solve the massive problem of animal homelessness. But at the same time, they contribute to the problems by keeping animals confined and not having the resources they need to fight disease and behavior issues."

Spaying, neutering

UC Davis began its specialized Shelter Medicine Program three years ago, with nearly $1 million in start-up money from Maddie's Fund, a nonprofit animal welfare organization. It has used the money to train veterinarians, to assess the causes of disease outbreaks at shelters and to begin to look for solutions to shelter health issues.

They are also working on problems that result in animal homelessness in the first place. Widespread spaying and neutering have reduced pet overpopulation over the past 20 years. But overwhelmed pet owners are turning in companion animals in larger numbers for behavioral problems. And some breeders still dump aging or ill animals at shelters when they can no longer produce profit-making litters.

Establishing standards

A long-term goal of the Shelter Medicine Program is to help establish standards for shelter animal care: What is ideal care? What should be minimal care? What level of disease is inevitable? What is acceptable? What can be done to minimize confinement-related behavior problems? And what are the most cost-effective solutions for cash-strapped communities?

Sacramento County, for example, in late August lost its only staff shelter veterinarian though county officials hope the vacancy is only temporary. The volume of animals euthanized has been rising, because the county doesn't have space to properly care for the 24,000 abandoned and homeless animals that end up at its aging cinder-block facility each year.

"I am always playing catch up," said Cindi Delany, the Sacramento County shelter veterinarian, during an interview shortly before her contract was ended in August and services were transferred to private providers. Delany, a 2000 D.V.M. graduate of UC Davis, had served in the position for two years.

"It's triage medicine. I can't give a complete physical to the 40 to 60 animals that end up here every day. But I can take a sneezing cat, put it on medicine and save its life. Or I can give pain medication to a dog that's been hit by a truck and has a broken leg."

'There is no time'

A typical day for Delany would begin with a quick scan of the shelter cage and a brief discussion with animal wardens about the most extreme cases. She would try to see the animals that had been left in the overnight drop boxes. She would administer shots of antibiotics, quickly clean wounds and give her attention to the animals with the best potential for adoption.

"If I were a regular neighborhood veterinarian, pet owners would bring their animals in and tell me everything about their little Flopsy or Mopsy. I'd know their life story," Delany said. "Here it's more like being in an emergency room with patients that can't talk. The animals I look at every morning are a blank slate. You have no history. You have to figure everything out from scratch. You can't do an extensive lab test on every one. There is no time."

After her initial rounds, Delany would head to the cramped trailer that had been serving as her operating room, office and triage center. There, on a steel table just inside the trailer door, atop donated sheets and towels, she and student interns performed as many as 25 to 35 spay and neuter surgeries each day for animals that had been adopted to new homes. She would also care for the injured and ill. One morning, for example, she performed two leg amputations on a dog hit by a car and another dragged behind a truck, and removed a tumor from a cat.

Delany's position had been one of the first to come from the UC Davis Shelter Medicine Program, which continues to work closely with Sacramento County to develop protocols to prevent disease outbreaks and hopes to help establish another on-site staff veterinarian.

Challenges, expectations

"This gives us a baseline of what we should be doing out there. Before this program was available, shelters were cleaning different ways, there was no thought to disease control, there was no standard," said Pat Claerbout, director of the Sacramento County Department of Animal Care and Regulation. "Obviously, making animals healthier makes them more adoptable. It does save lives daily."

At the time UC Davis started offering its first shelter-medicine course to its vet students, no other veterinary schools in North America had comprehensive programs to help new veterinarians handle the "herd-health" issues that are found when large numbers of homeless animals are concentrated in often substandard conditions. Now other major veterinary schools are incorporating shelter medicine into their curriculum.

"The challenge of being a shelter vet is that the sheer numbers can be overwhelming," Hurley said. "Burnout is a factor for these veterinarians. But the job is easier when they know what to expect and have some basic skills and protocols. Then they can easily save thousands of companion animals' lives."

Over the past three years, some 250 veterinary students, about one-third of all those attending UC Davis, have been immersed in shelter medicine through coursework and hands-on experience. Program director Hurley graduated in September of 2003 as the world's first official shelter medicine resident -- and hopes to soon have company. The field is attracting more students, who now are receiving support and direction.

But the UC Davis program aims to go well beyond educating veterinarians. It is charting an entirely new field of veterinary science. It has published the first articles to appear in scientific journals on shelter medicine-- on such topics as virulent systemic feline calicivirus. The highly infectious, deadly disease has killed cats in shelters, in rescue homes and even in suburban veterinary clinics. Hurley's published scientific research on the problem, however, prompted early recognition that prevented worse outbreaks as far away as Oklahoma and North Carolina.

A three-person team of disease detectives has collected samples from up and down the West Coast, providing assessments and studying conditions at shelters from Portland to Las Vegas -- with startling results. Blood tests from 20 dogs housed at one Nevada shelter -- a nonprofit organization with a no-kill policy -- revealed that 16 of the dogs had kennel cough, two had fatal distemper and nine tested positive for canine herpes, a lifelong disease.

Prevention touted

"We need to find out what the circumstances are that cause some diseases to spread more rapidly, so that we can find solutions for prevention," said Hurley, who has developed guidelines for shelters in handling ringworm, Parvo, kennel cough and panleukopenia, among other infectious diseases. And if care improves, so might the rate at which animals are adopted. Today, only about 17 percent of household pets in the United States are rescued from animal shelters.

Shelters working with the UC Davis program are serving as a model to help researchers learn how to control the worst killer of shelter cats--feline upper respiratory infection. The "common cold" of cats can wreak havoc in a shelter, and all too often leads to euthanasia for infected cats.

Former Oakland A's general manager Tony La Russa recently opened a nonprofit shelter in Walnut Creek, the Animal Rescue Foundation (ARF); it is one of the shelters helping UC Davis find answers.

"Together with UC Davis, we can be part of a solution. We can figure out the most effective ways to take care of cats who are sick, and then we can share that information so shelters all over the world can provide better treatment," said Brenda Barnette, executive director of ARF.

For details, visit http://www.sheltermedicine.com.